15 mot so nhan to anh huong den chat luong qtri

9{^hien aiu - Trao & MOT SO NHAN TO ANH Hl/CiNG OEN CHAT LUdNG QUAN TRj CONG CAP TINH: NGHIEN CUfU TRUCiNG HOP CHAT Ll/dNG DICH VU Y TE Cl LONG AN TS Le van Chie'n ^ r - ^ ndm 2009, ChUPng trinh Phat trien Lidn hidp qud'c (UNDP) phd'i hpp vdi i i Mdt tran To qud'c Viet Nam vd Trung tdm Nghidn edu phdt trien vd hd trp cpng dong tiln hdnh nghien cdu chd't lUpng quin tri cdng d p tinh trdn cd sd d i l u tra •^ kiln, danh gid eda ngUdi ddn v l c h i t lupng djch vu edng vd thd tyc hdnh ehinh ede d p chfnh quyln eung d p (PAPI) Cdng trinh nghien cdu dupe thye hidn trdn m l u dilu tra tai 30 tinh, p h i dgi didn eho ede vdng, miln cd nUde Nghidn edu ndy thu hut sy quan 1dm rdng rdi eua ngudi ddn bdi nd eho phep hp dua y kiln ddnh gid ve nhdng thdnh tyu edng nhu hgn e h l hoat dpng cda cdc d p chinh quyln tinh, huydn vd xa Ddng thdi, day cdn Id n^uln so lidu, thdng tin gid trj eho cdc nhd khoa hpc, nhd nghien cdu va qud trinh hoach djnh ehinh sdch d Viet Nam Ndm 2011, vdi sy giup dd cda UNDP, '•' Hpc vien Chinh trj - Hanh chinh qudc gia Hd Chi Mmh nhdm nghidn cdu thudc Hpc vidn Chinh trj - Hanh ehinh qud'e gia Ho Chf Minh da tiln hdnh nghien cdu mpt s l y i u t l "diu vdo" dnh hudng d i n chit lupng "diu ra" ciJa qudn trj edng d p tinh Nghidn edu ndy tip trung tim hilu nhdng khd khdn, thudn M md ede cd'p chinh quyln td tinh d i n xa phai dd'i mdt hdng ngdy, cd dnh hudng tryc tiep hole gidn t i i p d i n c h i t lupng djch vy vd thu tyc hdnh ehinh cdng Ndi cdch khdc nlu nhu PAPI ddnh gid k i t qud hoat ddng cija ehinh quyln cdc d p td gdc dp cua ngUdi ddn, ngUdi thy hudng djch vy (ddnh gid tiJ phfa d u ) thi nghidn edu ddnh gid hogt ddng cda cdc ddn vi eung dng djch vy cdng {ddnh gid td phia cung) Nghien cdu dUdc thyc hidn tgi tinh: Hdi Duong vd Nam Djnh (miln B I C ) , Long An vd Tien Giang (miln Nam) Ddy la cac tinh cd d i l u kidn ty nhifln typng dd'i giing nhUng danh gid cua ngudi ddn v l tdng mdt c h i t lUpng qudn trj cdng Igi khd khde Bdi v i l t gidi thidu mdt p h i n kit quS nghidn cdu, eu the la nhdng nhdn t l Inf* • • "4/2012 9{ghien cdu - Trao doi hudng d i n chat lupng djch vy y t l eda Long An o l lam ro nhdng y i u to nhU: nguin nhdn lpc, tdi ehinh, phUdng thde lanh dgo Inh hudng d i n chat lupng djch vy y t l eda tinh Long An, ehdng tdi so sdnh nhdng nhdn to ndy cda tinh vdi mdc chung cda cd nUdc va tinh Tien Giang Dieu kien tU nhidn, kinh t l - xa h$i tinh Long An Ve vi tri dia ly: Long An n i m vdng Ddng Thdp Mudi, thude D i n g b l n g Sdng Cdu Long; tllp gidp vdi Tp H i Chi Minh va tinh Tdy Ninh ve phia Odng, gidp vdi Campuchia v l phia Bdc, gidp vdi tinh Odng Thdp v l phia Tay va gidp tinh T i l n Giang ve phia Nam; Id tinh thupc vdng Kinh t l trpng diim phia Nam, dupe xdc dinh la vdng kinh te ddng lyc ed vai trd ddc bidt quan trpng chiln lupc phdt trien kinh t l cda Viet Nam; cd dUdng bien gidi qud'c gia vdi Campuchia ddi 137,7 km, vdi hai eda khau Binh Hidp (Mdc Hda) va Tho Mo (Ddc Hue), Dien tieh tu nhien eda Long An Id 4,491,4 km^ chiem ty Id 1,3% so vdi dien tich ca nudc vd bdng 8,74% dien tich cda vdng Dong bang Sdng Cdu Long Ve din so: Nam 2010, Long An cd khodng 1,4 tridu ngudi, chilm 10% ddn s l vdng Oing blng Sdng Cdu Long, 2% ddn s l cd nudc Trong dd, ddn s l sd'ng d ndng thdn chilm 82,5%, thdnh thj Id 17,5% Oilu ndy cho thd'y trinh dd phdt triln cda Long An v i n d mdc thip so vdi trung binh cda cd nude Mdt dd ddn s l Id 321 ngudi/km^ thip hdn mdt dd ddn s l trung binh eda vdng Ding blng Sdng Cdu Long (426 ngUdi/km^), eao gd'p 1,2 l l n mdt dd ddn s l trung binh ed nude (263 ngUdi/km^) Tinh hinh kinh te - xi hdi: Ndm 2010, gid trj ting sdn pham tren dja bdn tinh (theo gid hidn hdnh) dgt khoang 33.469 ty dong; theo gid ndm 1994 dgt khodng 12.777 ty ding, tdng 12,6% so vdi ndm 2009 Thu nhdp binh qudn dau ngudi tang td 23,1 trieu ding/ngudi {nam 2010) len 27,7 tridu ding/ ngUdi (ndm 2011),tUdng dUdng 1.113 USD/ ngUdi/ndm (xem Hinh 1) lUldt so' yeu to' dnh hUdng tdi higu qud cong tac qudn trj va hanh chinh cdng: Nghien cdu chat lUpng djch vg y te cdng Trong nghien edu cda PAPI, chat lupng djch vy y t l dupe nghien cdu d tryc ndi dung thd 6: "cung dng djch vy edng" Trong dd, PAPI nghien cdu dich vu cdng chd yeu, gom ITnh vuc y l l , giao dye lieu hpc cdng lap, Hinh 1: Thu nh$p binh quan dau ngUdi (tri$u d6ng/nam) cd sd ting cd bdn vd an ninh trdt ty Vdi ndi dung Long An dupe ddnh gia khd thap, ddng thd 22 s l 30 tinh dupe PAPI khdo sdt Trong nghidn edu nay, ehdng tdi chi tap trung khdo edu nhdng nhdn t l anh hudng den chat lUpng dich vy y te cdng (mdt ndi dung ma PAPI nghidn cdu) Theo Ngudn: Bio cio kinh te - xa hdi Long An nim 2011 •, tri _ QX Anmo 'J^ghiin cdu - Trao d k i t qud nghidn edu, chd't lupng dich vy y t l cdng eda tinh Long An thip hPn mde trung binh eda ed nudc nhung cao hdn so vdi Tiln Giang (xem Hinh 2) Nhan td' "diu vio" cua ITnh vi/c y te d Long An bao gdm: Thd nhi't, vi cd sd vit chi't vi ngudn tii chfnh: Tinh din ndm 2010, todn tinh cd 211 cd sd y t l , dd cd bdnh vidn tuyin linh, bdnh vidn khu vpc, 14 trung tdm y t l , bdnh vidn tu nhdn, vdi ting s l 3.332 giUdng bdnh, dd ed 2,440 giudng thudc cde bdnh vidn, s l edn Igl thudc cdc phdng khdm khu vpe, bdnh vidn dilu dudng vd cdc trgm y t l xa/phudng, S l giudng bdnh tinh trdn mdt van ddn {bao gdm giudng bdnh cdng Idp td phdng khdm da khoa khu vUc trd Idn, giudng y t l IU nhdn, phdng kham da khoa qudn ddn y, benh vien, benh xd) dgt mdc 23 giudng benh/vgn dan, tha'p hPn mde trung binh eda ea nUde (25,5 giudng bdnh/van ddn) nhung eao hdn so vdi mdc 19,1 giudng benh/van dan cua tinh Tien Giang mdc, thilt bj hu hdng thi benh vidn phdi ti/ bd l i l n d l sda chda Ngodi phin thu vidn phi (theo quy djnh eda Bd Y l l ) vd thu bdo hilm y t l , ndm 2011, cdc bdnh vidn d Long An dupe ngdn sdch Unh d i u tU 48 tridu ding/gudng bdnh/ ndm, thd'p hdn so vdi mde 52 tridu ding/ giudng bdnh/ndm d T i l n Giang Tuy nhidn, ndm 2010, mdc d i u tU cda Long An iai cao hpn so vdi T i l n Giang (Long An d i u tU48 tridu ddng cdn T i l n Giang chi d i u tU 27 trilu ddng/giddng bdnh/ndm) Ndm 2010, luy dupc danh gid cao hdn so vdi Tiln Giang nhung Long An vdn co k i t qud khd thip so 30 tinh dupe PAPI khdo sdt Nguydn nhan (theo k i t qua phdng v i n lanh dgo benh vien tinh) Id vien phi qua thap, khdng thay d l i td nam 1995, gay khd khdn eho cdng tdc khdm, chda benh, vi cdng khdm edng Id, khdng ed dilu kidn tai d i u tu Dd la tinh trgng ehung eua ede benh vien d Long An Thd hai ve ngudn nhin ldc: Toan tinh ed 4.438 edn bd y t l (ca cac benh vien cdng lap vd benh vien tu nhan), cd 2.796 can bd y le va 291 can bd nganh dupe, thude ede ed sd edng Idp (binh quan 19,3 edn bd y te vd can bd ngdnh dupc/ vgn dan) So vdi Tien Giang, ly le can bp y le/vgn ddn ciJa Hinh 2: Danh gia cua ngudi dan ve chat lu